Contract Details
Ancillary Care Services
Facility name
Monitor Medical
Provider ID
P000004616
NPI
1467785006
Tax ID
760338674
Effective Date
4/1/2012
Last Updated
10/9/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
1025 South Semoran Boulevard Suite 1093
Winter Park, FL 32792
United States
County
Orange
Phone
4076474030 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address